Evidence map›Paper›PMID 37675007›Full record

ArticleFrontiers in nephrology2022

Case report: Successful simultaneous heart-kidney transplantation across a positive complement-dependent cytotoxic crossmatch.

Takayuki Yamamoto, Daniel S Pearson, Emad I Ababneh, Cynthia Harris, Pitchaphon Nissaisorakarn, Grace K Mahowald, Yael K Heher, Nahel Elias, James F Markmann, Gregory D Lewis and 1 more

Open access · diamondAbstract readCase Reports
In one paragraph

Article in Frontiers in nephrology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.2field-weighted citation impact, top 45% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 1 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Takayuki YamamotoCenter for Transplantation Sciences, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States.
Daniel S PearsonHistocompatibility Laboratory, Department of Pathology, Massachusetts General Hospital, Boston, MA, United States.
Emad I AbabnehDepartment of Pathology, Massachusetts General Hospital, Boston, MA, United States.
Cynthia HarrisDepartment of Pathology, Massachusetts General Hospital, Boston, MA, United States.
Pitchaphon NissaisorakarnCenter for Transplantation Sciences, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States.
Grace K MahowaldCenter for Transplantation Sciences, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States.
Yael K HeherCenter for Transplantation Sciences, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States.
Nahel EliasCenter for Transplantation Sciences, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States.
James F MarkmannCenter for Transplantation Sciences, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States.
Gregory D LewisCenter for Transplantation Sciences, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States.
Leonardo V RiellaCenter for Transplantation Sciences, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States.
Massachusetts General Hospital · USHarvard University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Preformed donor-specific antibodies are associated with a higher risk of rejection and worse graft survival in organ transplantation. However, in heart transplantation, the risk and benefit balance between high mortality on the waiting list and graft survival may allow the acceptance of higher immunologic risk donors in broadly sensitized recipients. Transplanting donor-recipient pairs with a positive complement dependent cytotoxic (CDC) crossmatch carries the highest risk of hyperacute rejection and immediate graft loss and is usually avoided in kidney transplantation. Herein we report the first successful simultaneous heart-kidney transplant with a T- and B-cell CDC crossmatch positive donor using a combination of rituximab, intravenous immunoglobulin, plasmapheresis, bortezomib and rabbit anti-thymocyte globulin induction followed by eculizumab therapy for two months post-transplant. In the year following transplantation, both allografts maintained stable graft function (all echocardiographic left ventricular ejection fractions ≥ 65%, eGFR>60) and showed no histologic evidence of antibody-mediated rejection. In addition, the patient has not developed any severe infections including cytomegalovirus or BK virus infection. In conclusion, a multitarget immunosuppressive regimen can allow for combined heart/kidney transplantation across positive CDC crossmatches without evidence of antibody-mediated rejection or significant infection. Longer follow-up will be needed to further support this conclusion.

Indexed as

CDC positiveDSA positiveeculizumabheart transplanthighly sensitizedkidney transplant

Identifiers

PMID37675007
PMCPMC10479575
OpenAlexW4310207730

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.